Effects of a dialectical behavior therapy-based skills group intervention for obese individuals: a Brazilian pilot study

Eat Weight Disord. 2019 Dec;24(6):1099-1111. doi: 10.1007/s40519-017-0461-2. Epub 2017 Dec 2.


Purpose: This pilot study aimed to analyze the effects of an adapted dialectical behavior therapy (DBT) skills training group on problematic and adaptive eating behaviors in Brazilian obese individuals.

Methods: Thirty-one obese individuals were randomly assigned to 10 sessions of adapted DBT skills training (n = 14) or two months of a waiting list comparison condition (n = 17).

Results: Attrition rates were similar to what's been found in comparable studies, with most dropouts happening at the beginning of the treatment. Results showed improvements in binge eating severity (d = 0.80) and depression (d = 0.82) compared to no treatment condition. After the intervention, adaptive eating and distress outcomes showed an improvement trend, reaching nonclinical levels for most participants in the intervention group. Large to moderate between-group effect sizes were observed, but none of those were statistically significant. Large within-group effect sizes were observed in the intervention group in binge eating severity (d = 1.34), intuitive eating (d = 1.33) and depression (d = 1.12). Medium effect sizes were observed in emotional eating (d = 0.73) and in emotion regulation (d = 0.72). Despite positive outcomes in other variables, mindful eating worsened after the intervention (d = 0.66).

Conclusions: These results are preliminary and require further replications with larger samples, yet they suggest that the intervention may be useful to improve distress outcomes and adaptive eating among obese people. Implications for clinical practice and recommendations for future research are discussed.

Level of evidence: Level I, randomized controlled trial.

Keywords: Binge eating; Cognitive behaviour therapy; Dialectical behavior therapy; Emotion regulation; Obesity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Brazil
  • Bulimia / psychology
  • Bulimia / therapy*
  • Depression / psychology
  • Depression / therapy*
  • Dialectical Behavior Therapy / methods*
  • Emotional Regulation*
  • Feeding Behavior*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / psychology
  • Obesity / therapy*
  • Pilot Projects
  • Psychological Distress
  • Psychotherapy, Group / methods